1346772175 NPI number — MOLLY HILLENBRAND MD

Table of content: MOLLY HILLENBRAND MD (NPI 1346772175)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346772175 NPI number — MOLLY HILLENBRAND MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HILLENBRAND
Provider First Name:
MOLLY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346772175
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
315 TRENT DR DUMC BOX 102359
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DURHAM
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27710-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-668-6053
Provider Business Mailing Address Fax Number:
919-684-4971

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
DUKE CLINIC- CLINIC 1K 40 DUKE MEDICINE CIR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DURHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27710-2364
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-668-3197
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/30/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RI0200X , with the licence number: 2023-00433 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 35138681 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)